<!DOCTYPE html>
<html xmlns:th="http://www.thymeleaf.org"
      th:replace="fragments/layout(title='退款记录-编辑',jsPaths='/static/js/financial/refund/add.js')">
<div class="right" th:fragment="right">
    <!--面包屑-->
    <div class="breadcrumb layui-bg-gray">
                <span class="layui-breadcrumb" lay-separator=">">
                    <a th:href="@{/}">首页</a>
                     <a href="/receipt">收费管理</a>
                <a href="/refund">退款记录</a>
                    <a><cite>编辑</cite></a>
                </span>
    </div>

    <!--主体内容区-->
    <div class="form-content layui-container">
            <form class="layui-form" th:action="@{/refund/update}" method="post">
                <input type="hidden" name="id" th:value="${foodSampleModel.id}">
                <div class="layui-form-item">
                    <label class="layui-form-label must">老人姓名</label>
                    <div class="layui-input-block">
                        <input type="text" name="userName" th:value="${foodSampleModel.userName}" id="elderlyName" readonly required  lay-verify="required" placeholder="请点击选择老人姓名" autocomplete="off" class="layui-input">
                    </div>
                </div>
                <div class="layui-form-item">
                    <label class="layui-form-label must">老人编号</label>
                    <div class="layui-input-block">
                        <input type="text" name="userCode" th:value="${foodSampleModel.userCode}" id="elderlyCode" readonly  required  lay-verify="required|only" placeholder="老人编号" autocomplete="off" class="layui-input layui-disabled">
                    </div>
                </div>
                <div class="layui-form-item">
                    <label class="layui-form-label must">退款金额</label>
                    <div class="layui-input-block">
                        <input type="number" name="refundMoney"  oninput="if (value.length>7)value=value.slice(0,7) " step="0.01"
                               min="0" th:value="${foodSampleModel.refundMoney}"  lay-verify="required" placeholder="请输入退款金额" autocomplete="off" class="layui-input monery">
                    </div>
                </div>
                <div class="layui-form-item">
                    <label class="layui-form-label must">退款说明</label>
                    <div class="layui-input-block">
                        <input type="text" name="refundRemark"  maxlength="300" th:value="${foodSampleModel.refundRemark}" lay-verify="required" placeholder="请输入退款说明" autocomplete="off" class="layui-input">
                    </div>
                </div>
               <!-- <div class="layui-form-item">
                    <label class="layui-form-label must">操作人</label>
                    <div class="layui-input-block">
                        <input type="text" name="refundUser" th:value="${foodSampleModel.refundUser}"  maxlength="20" lay-verify="required" placeholder="请输入操作人" autocomplete="off" class="layui-input">
                    </div>
                </div>-->
                <div class="layui-form-item">
                    <div class="layui-input-block">
                        <button class="layui-btn  layui-btn-normal" lay-submit lay-filter="submitBtn">保存</button>
                        <a href="/refund" class="layui-btn layui-btn-primary">返回</a>
                    </div>
                </div>
            </form>
    </div>
</div>
</html>